Disease | Risk Associated with Disease | Adverse Events Associated with Vaccine |
Diphtheria | Case fatality: 5–10%
Complications are caused by the toxin released by the diphtheria bacteria and include upper airway obstruction, pneumonia, heart failure, and paralysis. |
Local reactions (redness, swelling and pain) increasing with age, the quantity of toxoid, and the number of doses received: 16% in children and 10% in adults
Fever and irritability occur less commonly |
Tetanus | Case fatality: 10%
Generalized rigidity and convulsive spasms of skeletal muscles. Severe spasms can cause fractures in the spine and long bones. Spasms in the larynx cause eating and breathing difficulties. |
Local reactions (same as above)
Lymphadenopathy and fever may occasionally occur Serum sickness, brachial plexus neuropathy, encephalomyelitis, and transverse myelitis rarely reported Risk of Guillain-Barre Syndrome (GBS) following immunization with a tetanus – containing vaccine is 0.4 per million doses of vaccine. |
Pertussis | 1-3 deaths each year in Canada, primarily in young infants.
Complications include; Apnea, Pneumonia: 5.2%, Seizures: 0.8%, Encephalopathy: 0.1% |
Mild fever in 3-5% of vaccine recipients
Local reactions (redness, swelling, and pain) increase with the number of doses received Moderate to severe systemic events are reported rarely with acellular vaccines |
Haemophilus influenzae type b | Meningitis: 55-65%
Meningitis case fatality rate: 5% (10-15% of Hib meningitis survivors have permanent neurologic sequelae and 15-20% have deafness.) Epiglottitis, pneumonia, septic arthritis, and cellulitis |
Local reaction (pain, redness, and swelling): 5-30%. Symptoms are mild and resolve within 24 hours. |
Polio | Aseptic meningitis: 1% of polio infections
Paralytic polio: 1% (25% of these will have post poliomyelitis syndrome) Death: 5-10% in paralytic polio infections ( 2-5% in children and 15-30% in adults) |
Local discomfort: 5%
No severe adverse events reported with IPV |
Measles | Febrile convulsions: 2%
Pneumonia, otitis media: 10% Thrombocytopenia:1/300 cases Encephalitis: 0.1% (1/1000 cases) (case fatality: 15%; neurologic sequelae: 25%) Death: 0.05-0.3% (1/3000 cases) Subacute sclerosing panencephalitis: 1/25,000 cases |
MMR vaccine:
Malaise and fever, with or without a non-infectious rash: 5% Parotitis: up to 1% Swollen glands, stiff neck or joint pains: 5% Transient arthralgia or arthritis more common in post-pubertal females (25% of post-pubertal females may experience arthralgia, and 10% may have arthritis-like signs and symptoms) Encephalitis:1 case per million doses Transient thrombocytopenia: 1 in 30,000 doses |
Mumps | Parotitis: 30-40%
Orchitis: 20-30% in post pubertal males Oophoritis: 5% in post pubertal females Deafness: 0.5-5.0 per 100,000 cases Encephalitis: 0.5% |
See MMR vaccine above. |
Rubella | Acute arthralgia or arthritis: 50% of adolescents and adults
Encephalitis: 1/6,000 cases Risk of Congenital Rubella Syndrome (CRS) is 85% in maternal infections in the first 10 weeks of pregnancy. CRS may include miscarriage, stillbirth, and fetal malformations such as congenital heart disease, cataracts, deafness, and mental retardation. |
See MMR vaccine above. |
Hepatitis B | Death: 1-2% due to fulminant hepatitis
Risk of chronicity depends on age at time of infection: infants: 90-95%; children 1-5years: 30-50%; adults: 5% Chronic carriers have an increased risk of hepatic cirrhosis and hepatocellular cancer (cause of up to 80% of hepatocellular carcinomas) |
Local reactions (tenderness, redness, swelling): 13-29% of adults and 3-9% of children
Fever (up to 37.7°C): 1% of adults and 0.4-6.4% of children Mild systemic symptoms such as fatigue, headache, and irritability: 11-17% of adults and 0-20% of children |
Human Papillomavirus (HPV) | HPV types 16 and 18 cause 70% of cervical cancer
HPV types 6 and 11 cause 90% of genital warts HPV causes 36% of oropharyngeal cancer; 24% of oral cancer, and 24% of laryngeal cancer Recurrent respiratory papillomatosis caused by HPV types 6 and 11 may be acquired from mother at birth or occur in adulthood |
Injection site reactions; Pain 83.9%, Swelling 25.4%, Redness 24.6%, Itching 3.1%. Systemic reactions; Fever 10.3%, Nausea 4.2%, Dizziness 2.8%, Diarrhea 1.2% |
Influenza | Viral and bacterial pneumonia
Death reported in 0.5-1 per 1000 cases; most deaths in persons ≥ 65 years of age During epidemics, there may be increased mortality and morbidity among the elderly, the immunocompromised and those with chronic disease |
Local reactions (soreness at injection site): ≤ 7% of children <3 years of age
Fever: ≤ 12% of children 1-5 years of age Headache, malaise, myalgia: <1% Risk of GBS estimated to be 1 excess case per million doses of influenza vaccine |
Meningococcal Disease | Meningitis is the most common presentation of invasive disease.
Meningitis case fatality: 5-10%. Septicemia: 5-20% of cases Pneumonia: 5-15% of cases Arthritis: 2% of cases Otitis media and epiglottitis: <1% of cases Sequelae occur in up to 20% of survivors and include hearing loss, neurologic damage, loss of limbs from gangrene, and kidney damage. |
Conjugate vaccines: Local reactions(redness, tenderness, and swelling at injection site): up to 50% Irritability: up to 80% of infants Fever >39°C: up to 9% (when given at same time as other vaccines) Headache and malaise: up to 10% of older children and adults Severe reactions: < 0.01% Risk of GBS associated with quadrivalent conjugate meningococcal vaccine continues to be monitored Local reactions (pain and redness): up to 50% |
Pneumococcal Disease | Pneumococcal pneumonia is an important cause of death in infants and the elderly.
Case fatality rate is 5-7% overall (much higher among the elderly) Most common cause of bacterial meningitis. Case fatality rate is 30% (up to 80% among the elderly) Bacteremia: case fatality rate is 20% (up to 60% among the elderly) Otitis media |
Conjugate vaccine:
Local reactions (pain, swelling, or redness at injection site): 10-20%; Fever: 15-24% (when vaccine administered at the same time as whole cell pertussis vaccine) Polysaccharide vaccine: Local reactions: 30-50% Fever: 2% Irritability, drowsiness, restless sleep, decreased appetite, headache, malaise may occur with conjugate or polysaccharide vaccine |
Varicella | Secondary bacterial infections: 5-10%
Low platelets: 1-2% Cerebellar ataxia: 1/4000 cases Encephalitis:1/5000 cases Invasive group A Streptococcal infection: 5/100,000 cases Death (per 100, 000 cases): Adults: 30 deaths Infants < 1year old: 7 deaths Children 1-19 years old: 1-1.5 deaths Otitis media, bacteremia, pneumonia, osteomyelitis, septic arthritis, endocarditis, necrotizing fasciitis, toxic shock-like syndrome Reactivation of varicella virus as Herpes Zoster (shingles) later in life: 20% Congenital varicella syndrome: up to 2% of fetuses born to mothers infected at 13-20 weeks gestation |
Varicella like rash at injection site: 3-5% after the first dose and 1% after a second dose
Small number of generalized varicella-like papules or vesicles: 5% after the first dose and 1% after a second dose Fever: 10-15% Local reaction (pain, swelling, and redness at injection site): 10-20% Risk of zoster after vaccination: 2.6/100,000 vaccine doses No deaths or congenital varicella have been attributed to vaccine. |